Provider Demographics
NPI:1871832022
Name:MICHIELS, ELIZABETH B (MS CCC/SLP)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:B
Last Name:MICHIELS
Suffix:
Gender:F
Credentials:MS CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1226 ASHLAND DR
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-4815
Mailing Address - Country:US
Mailing Address - Phone:469-233-4753
Mailing Address - Fax:
Practice Address - Street 1:2231 HWY 80 E
Practice Address - Street 2:WILLOWBEND NURSING & REHAB
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75150-5510
Practice Address - Country:US
Practice Address - Phone:972-279-3601
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-07
Last Update Date:2013-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17847235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist